seo by DrAnil Shinde

Search Engine Optimization: Buyer Beware SEO for the Dental Practice

A Paper By David W. Evans, Ph.D., MBA

Table of Contents: I.

Introduction (Dentistry, the Internet, and SEO)

II.

Background (SEO and search engine ranking) a) Search Engine Databases (All search engines create a database) b) Spiders and Human Editors (Two tools used by search engines to establish ranking)

III.

Avoid Black Lists – Don’t Hire a Trickster a) Spamming i. Keyword Stuffing ii. Spamdexing iii. Hidden Links b) Cloaking c) Redirecting d) Submission Software e) Page Jacking

IV.

Questions to Ask SEO Firms

Conclusion: Search Engine Optimization Done Right

Purpose With patients flocking to the Internet by the millions to learn more about dental procedures, dentists are increasingly coming to understand the importance of developing an Internet strategy. Because the Internet is a veritable sea of information, ‘being found’ has been clearly identified as the most critical component, and therefore the focus, of any successful Internet strategy. A web page that is well thought out and designed is of no value if it is not seen. Search engine optimization (SEO) seeks to enable dentists’ websites to be seen by getting them highly ranked on the search engines. Unfortunately, many unscrupulous marketing companies have included largely questionable practices in their Internet traffic packages, lumping them under the umbrella of search engine optimization. Because of this and due to the fact that dentists are continually bombarded by marketing information, it is very difficult for them to discern which SEO firms are credible and which are not. It is in this environment that Einstein developed “Search Engine Optimization: Buyer Beware,” as a tool to help dentists understand some of the tricks and jargon they will encounter while searching for a reputable SEO firm. This paper will explain what defines “SEO tricksters,” how to steer clear of them, and how to locate a sound SEO firm.

I. Introduction People are looking for dental information on the Internet in massive numbers, and they prefer that it be provided by dentists themselves. Of the over 100 million consumers who sought healthcare information online in 2001, 77% said they preferred to learn from a healthcare professional’s website rather than a commercial portal. 1,2 The Internet is crowded, however, and most of the advertising space is already taken. So how can you as a dentist provide the information Internet users are looking for and ensure that they can find it? The answer is easy -- search engine optimization (SEO), or more simply put, a strategy that seeks to get your website highly ranked on the search engines. Sound good? It is. A good SEO team can dramatically impact your procedural volume by driving patients in exponentially higher numbers to your practice website and, ultimately, into your practice. But don’t race to the nearest SEO firm just yet. When shopping for an SEO provider, pitfalls abound. With virtually no existing standards or regulations governing it, search engine optimization is truly a buyer beware market. In this paper, Einstein Dental provides you with tips for avoiding SEO pitfalls. Einstein has extensive experience in the field of search engine optimization. We have been practicing SEO techniques for over four years—longer than search engine optimization has had a name. As a result, we are in the unique position of having studied the SEO market for healthcare while it developed. It is from this experience that the advice found in this paper is derived.

II. Background In order to fully understand the concept of search engine optimization, it is first necessary to understand the chaotic environment of the Internet. The Internet is currently a sea of information in which search engine ranking--the process by which search engines rank the sites that they file in their databases--can make or break any website. Unless you are buying advertising positions on the Internet, search engine ranking determines whether or not a patient will find your practice website. Search Engine Databases All search engines create and rely upon a database of websites. In order to have your website rank highly on a search engine, it must be properly positioned in the search engine’s database. Search engine databases can be compared to the index card files you used to find in the library. Reference information about a website is stored in the search engine databases the way the old index card system filed information on a book. Search engines take it two steps further, however, by storing not just the reference information but also the entire website, then allowing you to search by keyword(s). Currently, search engines are required to index an exorbitant amount of information and put it into a searchable database. This situation has given rise to two search engine tools: spiders and human editors.

Spiders and Human Editors Search engines use two main tools to choose sites for their databases and then rank them: spiders and human editors. Spiders (also known as automatic robots) rank websites in the search engine databases based on algorithms that analyze the content and html codes of each website. Spiders work by “crawling” around the Internet in search of little morsels of information on different subjects. They detect the information they are looking for through keywords and other key elements of the website, and combinations of elements. When attempting to optimize a website, search engine optimization experts do their best to feed the spiders what they want. Unfortunately, there are no standards for website construction; these days, websites are written in many different languages that cannot be read by spiders. Enter the human editor. Human editors are just what they sound like – real live people employed by directory-based search engines to rank websites that have been deemed appropriate for their databases. Directory-based engines require that you submit a form to their human editors for this purpose. Your website must reflect good research and provide good content to impress human editors. Charming them is a bit like making porridge for Goldilocks: one thing will be considered too hot, another too cold. Your job is to get it just right. Most search engines use a spider/human editor combination to create their databases and determine website rankings. And since the Internet is completely jammed with websites on every topic, even good sites have been forced to devise optimization campaigns to try and charm the search engines. Optimization seeks to build a website that search engines both understand and like. Tricksters, however, have partially succeeded in hijacking the field of SEO. Unfortunately, far too many of these tricksters operate thriving businesses that attract unsuspecting customers.

III. Avoid Black Lists – Don’t Hire a Trickster Your success with search engine optimization begins and ends with the firm you choose to perform your SEO campaign. There are several guidelines to follow in making this choice. Perhaps the most important thing to look out for when searching for an SEO firm are SEO tricksters. These firms try to fool search engines in order to get your website highly placed in the free listings; this is both unnecessary and dangerous for your practice – unnecessary because tricks are nothing more than a poor replacement for good website development, dangerous because if you get caught you could get blacklisted by the search engines. (Blacklisting is the practice wherein search engines bar a website from being indexed in the search engine’s database. It is covered in more detail below.) Not long ago, a common ruse used by SEO tricksters was to load a site with ‘invisible’ keywords. They accomplished this by typing these words in the same color as the web page’s background. In this way, they hoped that the website content would match the criteria of the search engine spider algorithms and then rank the site highly in the free listings. While “tricks” like this may at first sound impressive, stop and think. Search engines are the royalty of the

Internet; why would they allow tricksters to subvert their domain? Search engines detest the idea of someone circumventing their systems. As such, they employ the best Internet technology available to isolate and block people attempting to do so. In the example above, what the tricksters did not consider was a team of human editors aided by this technology and trained by the search engines to locate and quickly ‘blacklist’ sites that employed these tactics. All major search engines maintain a black list. This is simply a list of websites that are designed to “trick” the search engines to attain an unfair advantage. Becoming a persona non grata with the search engines is the last thing you want if you intend to establish an Internet presence for your practice website. If your website gets blacklisted by the search engines, it will cease to be indexed, preventing it from obtaining any future traffic from the search engines. In addition, your website will lose already established traffic. To prevent this from happening, avoid at all costs unscrupulous firms that employ search engine no-nos as part of their SEO strategy. Prior to signing a contract with an SEO firm you are considering, interview them to make sure they have no intention of using any illegal techniques, each of which is described below. For the purpose of clarity, in this paper these techniques are grouped into five categories: spamming, cloaking, redirecting, submission software, and page jacking.

Spamming Spamming involves any attempt to deceive search engine spiders into believing that a site contains content or information that in reality it does not contain. This includes keyword stuffing, spamdexing, and hidden links. Keyword Stuffing – involves taking a keyword and repeating it over and over in order to attract the attention of search engine spiders. Keyword stuffing is oftentimes placed in a hidden spot on the website, e.g. at the bottom of the page in small font. For example, a cosmetic dentistry site using keyword stuffing might include a small, hidden version of the following text: veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers veneers. In some cases, companies have included hidden keywords that are not related to the subject of their website in order to gain traffic from different market segments. This is common in the gaming industry, where the website owners want to attract visitors for virtually every widely used search term, such as “cars” or “stock market.” This tactic obviously only serves to aggravate search engines, who invariably locate such sites and promptly blacklist them. A preferable method of inserting keywords is to include them in a highly dense but appropriate manner within the site’s content. This is known as “keyword density.” On the imaginary cosmetic dentistry site mentioned earlier under keyword stuffing, you might find the following example of keyword density: “Veneers, or more specifically porcelain veneers, are used to improve the appearance of a patient’s smile. Veneers are used by cosmetic dentists to fix cracked, chipped, or stained teeth.” In this example, the keyword “veneers” is used three times (rather than replacing it with the word “it” in the second sentence) and the keywords “cosmetic dentist,” “smile,” and “teeth” are also included. While the optimizer has cleverly repeated the most important word (veneers), he or she has avoided the dangerous practice of keyword stuffing.

Spamdexing – is the same thing as keyword stuffing but is carried out in the site’s code as opposed to on the web page. The end effect is the same. Hidden Links – are used by tricksters for more than one purpose. One trick is to attempt to “convince” the search engine spiders that your site is part of a greater ‘community.’ This is done by including hidden links that have nothing to do with the subject at hand. For example, if a dentistry site is packed with hidden links containing the words “Anna Kournikova,” it may convince a search engine spider looking for this popular search term that this site is popular with Anna Kournikova fans. Hidden links are disguised by attaching a link to an object on the page (as in a picture). Alternatively, like invisible keywords, hidden links can be disguised by using the same color as the background of a given page. Also similar to invisible keywords, human editors loathe hidden links and would love nothing more than to blacklist your site if you include them, whether they like Ms. Kournikova or not.

Cloaking Also known as the “food” technique, Spider Feeding, and IP delivery, cloaking is a strategy that, when used appropriately, gives both search engines and consumers visiting your site what they want. However, SEO tricksters have made cloaking extremely unpopular in some circles. Here’s how it works. Every consumer and spider searching the Internet has an IP (Internet provider) number. When a spider visits a site, its IP number is clearly identifiable. Some search engine optimizers have designed scripts (computer programs) capable of recognizing spiders by their IP numbers. When a spider “crawls” the Internet looking for specific content, a cloaked site can deliver a completely different site to the spider than it would to a consumer. The “cloaked site” contains only the content designed specifically to satisfy the requirements (or algorithm) of the spider. Under which circumstances cloaking is appropriate is a subject of considerable debate. This dispute has arisen because, as with other SEO strategies, the practice of cloaking has been abused by unscrupulous optimizers. A script that sends the spider only the content of the website, without design elements such as Flash, is arguably considered acceptable cloaking. (Some design elements like Flash can mask website content from the spiders.) However, if an optimizer intentionally sends the spider content that does not accurately reflect the content of the website, this is considered inappropriate. SEO tricksters often use this form of cloaking to hide the fact that they have stolen copyrighted material or to disguise the use of irrelevant keywords. For example, it is not unusual for Internet-based businesses from the pornography industry to place cloaked pages on their sites for high traffic key words such as “cars.” A search engine spider would then rank the website highly for the content related to cars. An unwary consumer would click into the site thinking it was a website for cars, only to find that he or she is visiting a pornography website. To illustrate an example of inappropriate cloaking in dentistry, imagine an SEO firm hired by a dentist in New York to optimize his website. When a spider crawls looking for information on “New York dentists,” it is fed information not only about the dentist in question, but also about all of his competitors. When a consumer comes along, however, he or she sees only information

about the dentist who hired the SEO firm. If a search engine catches the SEO firm doing this, the site will be blacklisted, and rightfully so.

Redirecting If you have ever typed an incorrect web address into the address box of your browser but been directed to the site you wanted anyway, you probably experienced redirecting. Like cloaking and other search engine optimization techniques, redirecting has both acceptable and unacceptable applications. Einstein Dental, for example, uses an accepted form of redirecting for its popular healthcare site imagineyourhealth.com, formerly vabyourhealth.com. When someone mistakenly types the old name (vabyourhealth.com) he or she is redirected to imagineyourhealth.com. This is considered an appropriate use of redirecting by the search engines because Einstein is helping the Internet user reach the site he or she intended to reach. Redirecting is considered unacceptable by the search engines when the technique is used by an SEO optimizer to direct someone away from the intended site – to a site of the optimizer’s choice. This is accomplished by creating a site on one topic, then redirecting Internet users to another website dealing with another topic when they try to access the site. The first site is built in such a way as to target search engine spiders and human editors. Once the site has been “crawled” by the spiders or approved by the human editors, the SEO optimizer redirects the site’s traffic to another site of his choosing. Remember the aforementioned pornography business that placed ‘cloaked’ pages on its website for the popular keyword “cars” in order to steer auto enthusiasts to its site? This same company might construct a legitimate car-related website and then use redirecting to drive unwilling consumers to its pornography site. This would be considered dishonest trickery by the search engines, possibly leading to blacklisting of the perpetrator’s website.

Submission Software Submission software, like its name suggests, is software that submits a website to the search engines for indexing. While this software does not necessarily in itself offend search engines, certain submission packages contain questionable elements. One reason to avoid submission software is its tendency to submit your site to “link farms,” or web rings—website communities on a given subject that raise a red flag with search engines, which consider web rings an artificial method of creating links to your site. Many submission software packages make the dubious claim of being able to submit your website to “thousands” of search engines. Even if there were thousands of search engines, which there are not, it would be inadvisable to have your website submitted to all of them at once. First, since three search engines (MSN, Yahoo!, and Google) dominate the healthcare sector of the Internet, there is no need to have your website submitted to the masses of inferior sites professing to be search engines. Furthermore, by indiscriminately blasting your site into cyberspace without regard for each engine’s specific rules, this software increases your website’s chances of being blacklisted. Some software packages also tout their ability to resubmit a site every 30 days. But the time period for re-submission varies from search engine to search engine. For example, many search

engines only allow a site to be resubmitted for indexing every six months. If a site is “oversubmitted,” it runs the risk of aggravating the search engines, thereby keeping the website from being indexed. There are other reasons to avoid submission software. Why should you trust a computer program to accurately perform such an important task as submitting your site for indexing? Submission software shifts control of the submission from you to a computer algorithm. If the software makes a mistake, no one will see your website. If there were no other reason to avoid submission software, this would be reason enough to do so.

Page Jacking – playing with the hottest of SEO fires Page jacking refers to the practice of misappropriating a website’s copyrighted or trademarked content or code for the purpose of optimizing a website. This practice varies from using someone else’s optimized code to pilfering both the code and content. In both scenarios, these stolen website elements are used to gain a higher position on the search engine results pages (free listings). Since the page-jacked material typically originates from websites that are highly ranked on the search engines, the material contains website content or coding compatible with the algorithm of the search engine spider. Page jacking entails hiding (cloaking) stolen pages within a website where only search engine spiders can see them. When a spider “crawls” the website, it finds many pages that match the criteria of its algorithm. The page jacking causes the site to be ranked highly even though the primary content or coding of the site is not ranked well by the algorithm. An example of page jacking would be a cosmetic dentistry website that was programmed to present to the search engine spiders stolen material from another dentistry site that has a high ranking on the search engines. Because page jackers use cloaking, it is very difficult to know if a site contains copyrighted or trademarked material from another website. However, since page jacking is considered theft, the consequences are much higher than other forms of SEO chicanery. Numerous cases have been brought to court, and businesses have been bankrupted. Hence, it goes without saying that you should make sure your SEO firm does not use this practice.

IV. Questions to Ask SEO Firms When approaching an SEO firm, there are many questions you should ask, including some that deal with issues outside the realm of inappropriate SEO tricks. In this section we include a range of questions to ask, along with an explanation as to their significance. Do you have good references? Someone claiming to be an SEO guru had better have references to back it up. In a field chock full of tricksters, it is imperative that you verify the claims made by firms you consider. The best way to do this is through references. While you’re at it, ask them for a list of keywords to test the accuracy of their claims. Then go to one of the top search engines (MSN, Yahoo!, or Google) and type one of these keywords into the search box. If the site they told you would appear near

the top of the results page does in fact appear, you know they are legit. (Note: if someone tells you a site will be the number one listing and you discover that it is number three, this is good enough. Search engine placement can change one or two positions from day to day.) Do you outsource your SEO services? Different types of firms now offer SEO services, from full-service marketing agencies to PR firms to website design companies. Not all of them have in-house SEO experts (most, in fact, do not) but this does not necessarily mean that you should not choose them. However, if your firm of choice does outsource SEO services, you need to be able to contact their expert directly. More importantly, you must be sure that there is a system of shared liability between the firm and its outsourced expert. In other words, the firm must take at least partial responsibility for the actions of its SEO expert, regardless of whether he or she is an in-house employee. Otherwise, you could be stuck with the blame and/or consequences of anything the SEO expert does. If the firm’s SEO contract does not share liability for its SEO expert’s methods, this is a bad sign. Remember that hiring a firm that outsources adds one more layer between you and the person working on your website. Do you have at least one full-time person working on nothing but SEO? Ensure that the person optimizing your website is an expert in search engine optimization who works full-time on SEO. You do not want a part web designer/part SEO optimizer in charge of your site’s performance. The field of search engine optimization is too dynamic for a part-timer to stay abreast of the changes in SEO requirements. What do you do to avoid black lists? This question should prompt a passionate answer. A good SEO firm will go on a virtual tirade about its efforts to avoid being blacklisted by search engines. For example, placing information regarding heavy metal bands on a site with the domain name bingos.com obviously runs the risk of leading astray a senior citizen or two. If a human editor stumbles upon such a site, the consequence will likely be blacklisting of the site. Therefore, if you ask a firm whether it avoids such flagrant violations of search engine principle, the answer should be a resounding “yes.” Do you avoid red flags? Some SEO tricks, such as ‘improper’ redirecting, may not be cause for automatic blacklisting on the part of search engines. Even so, these practices may raise a red flag. Does a firm engage in questionable practices like improper redirecting? If so, walk out the door. Do you develop relationships with the search engines? No one calling themselves an SEO expert should be bashful when communicating with the search engines. A successful optimizer should be able to call his or her contact at Yahoo!, MSN, Google, or other major search engines with any question. The only way to know for sure what is and is not considered appropriate by the search engines is by going straight to the horse’s mouth -- the search engines themselves.

Do you understand my market? After researching a number of different firms that offer SEO services, you’ve narrowed it down to a couple diamonds in the rough. Now you’re trying to assess which one to hire. Both fit the bill, with a proven SEO track record and all of the other necessary factors. Consider going with the firm that has experience in the dental industry. Although this may seem obvious, believe it or not many practices make the mistake of choosing a firm that is technologically advanced but lacks the necessary background to manage an SEO campaign that is effective—and appropriate—for a dental practice. Imagine a consumer coming to a cosmetic dentist’s website and finding the phrase “100% satisfaction or your money back!” It may sound crazy, but this is what can happen if you choose the wrong firm to optimize your website. For this reason, it behooves you to seek out a firm that combines SEO expertise with writers who are knowledgeable about dentistry.

V. Conclusion: Search Engine Optimization Done Right Constructing a well-designed, effective website that is optimized for search engine placement should not be difficult, so long as you do your homework. After interviewing the SEO firms you are considering, there are only a few things to keep in mind before making a decision. Strive for honest, quality website content and design, without falling for scams or shortcuts that SEO tricksters and profiteers would have you believe in. Remember, there is no substitute for good website development.

Harris Interactive, April 2001, Jupiter Research, April 2002.

Sources: Muller, Anthony and Tim Gibbon. Buyer’s Guide to Search Engine Optimization & Positioning Services. Ed. Anne Holland. 1st ed. Washington DC: MarketingSherpa, Inc., 2001. Planet Ocean Communications. “Chapter 3: Tricks & Illusions.” The Unfair Advantage Book on Winning the Search Engine Wars. (1 April, 2002). Boutin, Paul. “Search Engine Optimization FREE!” Webmonkey. (6 August, 2001). Sullivan, Danny. “Jupiter Media Metrix Search Engine Ratings.” SearchEngineWatch.com. (29 April, 2002). Taylor, Humphrey. “Cyberchondriacs Update.” The Harris Poll #19 (18 April, 2001).

About the Author David W. Evans, Ph.D., MBA, has published a number of articles and presented lectures to audiences worldwide, including lectures on dentistry and the Internet. Dr. Evans was formerly co-founder and President of Vistech Consultants, Inc. He is a faculty member at the University of Alabama, Birmingham, and continues to hold his position as President and CEO of VectorVision, Inc., where he developed and patented a vision diagnostic instrument currently used in 45 countries. He also holds five United States patents. Dr. Evans received his undergraduate training at the United States Air Force Academy and obtained an M.S. in systems engineering and an MBA from Wright State University. He holds a Ph.D. in ocular physiology from Indiana University.

Other Einstein Publications: Silkey, Robert C. “Three Ways to be Found on the Internet,” ed. Nathan Johnson (San Diego: Einstein Publishing, 2002). Evans, Dr. David W. “Creating an Effective Website,” ed. Nathan Johnson (San Diego: Einstein Publishing, 2002). Silkey, Robert C. “The Five Essential Components of an Effective Internet Strategy,” ed. Nathan Johnson (San Diego: Einstein Publishing, 2002). Upcoming Publications… HIPAA Compliancy and the Internet, by Robert C. Silkey. (Scheduled for publication in 2004.)

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